Personal Bankruptcy and Health Care Reform

Republican, Democrat, Left, Right, Centrist… No matter how citizens in this nation may choose to politically identify ourselves, we are all pretty much in agreement about one thing: This country needs health care reform. Our suggestions as to what shape that reform should come in may not be identical but there is no denying that we are currently on the fast track to bankruptcy if meaningful reform is delayed much longer.

In fact, many individual Americans have already been bankrupted through devastating encounters with our current health care system. This past summer, the respected American Journal of Medicine released new study findings that revealed some staggering statistics that reveal the role that medical expenses play in personal bankruptcy filings. Working to reduce the margin of error in their findings, the authors applied a stringency to the study that made it a first of its kind: a truly random sample of bankruptcy filers nationwide, followed up with detailed personal interviews of participants. Medical causes of bankruptcy were defined to include medical bills and loss of income due to health issues. In conclusion, they discovered that more than 60% of personal bankruptcy filings in 2007 had significant medically related expenses that pushed individuals and families over the financial edge to file for bankruptcy.

Steffie Woolhandler, M.D., one of the study's authors, appeared in a CNN interview saying "If an illness is long enough and expensive enough, private insurance offers very little protection against medical bankruptcy, and that is the major finding in our study." As a counterbalance Dr. Woolhandler's bracing conclusions, the nonpartisan policy research foundation, the Center for Studying Health System Change, voiced mild skepticism of the study's weighting of medical causes for bankruptcies. But they also offered little comfort with their statistic that 1 in 5 American families are "unduly strained" by medical bills.

In 1981, only 8% of families filing for bankruptcy claimed to have done so in the wake of a major medical crisis. (The accuracy of that figure is somewhat debatable since court records do not indicate the origin of debt that is handled by collection agencies, possibly obscuring debt generated by doctor or hospital bills.) In 2001, a major study concluded that over 46% of personal bankruptcies were medically related. The American Journal of Medicine study's most recent conclusions of 61% used data from 2007, indicating an alarming trend and numbers which interestingly predate the fallout of our economy's current recession.

The stigma that hangs over personal bankruptcy in our country is in part due to the public's common misunderstanding of what the average filer looks like; many people have a mental image of a hapless slouch. The American Journal of Medicine's study reveals this misapprehension for the untruth that it is. Most of the debtors surveyed were middle class, middle aged and college educated. 75% of the debtors had health insurance coverage at the onset of their financial and health problems. Typically this insurance left them with the commonplace gaps of high premiums, copayments, hefty deductibles and a range of uncovered medical services. It is important to note that policy rescission is a normative practice among medical insurance companies with 25% cancelling an individual's policy immediately upon a disability diagnosis and another 25% of companies cancelling within one year of the diagnosis.

It is hard to ignore that the middle class' back is being gradually broken under the weight of the current insurance system. Health insurance premiums skyrocket every six months and deductibles on most policies follow a similar skyward pattern annually. Proponents of the American Dream have traditionally contended that what is bad for the middle class is bad for the nation as a whole. Currently, it is estimated that the U.S. will spend 17.6% of its GDP (Gross Domestic Product) on health care in 2009. The future holds an ever upward spiral if reforms are not soon brought into play. A further consideration of this staggering GDP statistic is to realize that it does not and cannot take into account all the associated costs that medically related bankruptcy of individuals or small businesses impose on the economy and society.

Do a quick online search for this American Journal of Medicine study and review it in its entirety for yourself (www.amjmed.com, Vol. 122, Issue 8 pp. 741 to 746). As a citizen, you owe this brief time investment to both you and your country. Inform yourself and do not leave decision making of this kind solely and silently in the hands of your elected officials. It doesn't hurt to remember that your representatives have plump health insurance packages that the average Joe is barred from participating in.